氯沙坦联合尼群地平对非杓型老年高血压患者血压昼夜节律及血压晨峰的影响  

Effect of losartan and nitrendipine therapy on circadian rhythm of blood pressure and morning blood pressure surge in elderly patients with non-dipper hypertension

作　　者：李静[1,2] 查道刚[1] 刘学员[2] 

机构地区：[1]南方医科大学南方医院心血管内科,广州510515 [2]解放军第181医院干部病房,广西桂林541002

出　　处：《岭南心血管病杂志》2015年第5期659-662,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的观察氯沙坦联合尼群地平对非杓型老年高血压患者血压昼夜节律及血压晨峰的影响。方法选择解放军第181医院2011年1月至2015年4月期间诊治的198例非勺型老年原发性高血压患者为研究对象,按随机数字表法分为对照组和治疗组,每组99例。经14 d安慰剂洗脱后对照组睡前服用氯沙坦50 mg,治疗组晨起后加服尼群地平10 mg,持续用药12周。比较两组治疗前、后血压变化,对比血压昼夜差值百分比及清晨血压平均值及达标率。结果两组治疗后24 h平均收缩压、24 h平均舒张压、收缩压白天平均值、舒张压白天平均值、收缩压夜间平均值、舒张压夜间平均值、晨起平均收缩压、晨起平均舒张压值、血压晨峰均较治疗前明显降低,差异有统计学意义(P<0.05)。治疗后,治疗组24 h平均收缩压、舒张压水平,白天收缩压、舒张压平均水平,晨起平均收缩压、舒张压水平,血压晨峰值均明显低于对照组,差异有统计学意义(P<0.05)。且治疗组在显效率和总体有效率上明显高于对照组,治疗组血压昼夜差值亦明显高于对照组,差异均有统计学意义(P<0.05)。结论睡前服用氯沙坦联合晨起服用尼群地平可调整非杓型老年高血压患者血压昼夜节律,并降低血压晨峰,值得在临床上推广。Objectives To study the effect of losartan potassium and nitrendipine on circadian rhythm of blood pressure and morning blood pressure surge in elderly patients with non-dipper hypertension. Methods The objects of this prospective study were 198 elderly patients with non-dipper hypertension in The 181 stHospital from January 2011 to April 2015. They were randomly divided into control group and treated group according to a random number table, with99 in each group. After a washout period of 14 days, in control and treated groups, 50 mg losartan potassium in tablets was administrated before sleep, and 10 mg nitrendipine administrated in the morning was added in treated group for12 weeks. The changes of blood pressure and efficacy before and after treatment between the two groups were compared.Results After treatment, mean 24-h systolic blood pressure, mean 24-h diastolic blood pressure, mean daytime systolic blood pressure, mean daytime diastolic blood pressure, mean nighttime systolic blood pressure, mean nighttime diastolic blood pressure, mean morning systolic blood pressure, mean morning diastolic blood pressure and morning blood pressure surge in both groups significantly declined than those before treatment（P〈0.05）. Compared to control group, mean 24-h systolic and diastolic blood pressures, mean daytime systolic and diastolic blood pressures, mean morning systolic and diastolic blood pressures and morning blood pressure surge in treated group were significantly lower（P〈0.05）. In addition, the significant and total efficacy, pressure circadian in treated group were much better than those in control group（P〈0.05）. Conclusions Applying losartan potassium before sleep combined with nitrendipine in the morning can adjust the circadian rhythm of blood pressure and lower the morning blood pressure surge in elderly patients with non-dipper hypertension, and it is worthy of promotion.

关 键 词：非勺型老年高血压 血压晨峰 氯沙坦 尼群地平 

分 类 号：R544.1[医药卫生—心血管疾病]